Organization
ST JOSEPH'S DIALYSIS
Active
Parent organization
ST JOSEPHS HOSPITAL HEALTH CENTER
Other names
CORTLAND DIALYSIS
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST JOSEPHS HOSPITAL HEALTH CENTER
Authorized official
MARK WAITE (DIRECTOR)
(315) 703-6777
Entity
Organization
Contact information
Practice address
3993 WEST RD, CORTLAND, NY 13045-1843
(607) 662-0140
(607) 662-0519
Mailing address
973 JAMES ST, SYRACUSE, NY 13203-2524
(315) 703-6700
(315) 703-6762
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00315013
—
NY
05
—
02995893
—
NY
Enumeration date
01/12/2007
Last updated
07/31/2009
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